Associations between hospital deaths (HSMR), readmission and length of stay (LOS): a longitudinal assessment of performance results and facility characteristics of teaching and large-sized hospitals in Canada between 2013–2014 and 2017–2018

Objectives To examine the association between hospital deaths (hospital standardised mortality ratio, HSMR), readmission, length of stay (LOS) and eight hospital characteristics.Design Longitudinal observational study.Setting A total of 119 teaching and large-sized hospitals in Canada between fiscal years 2013–2014 and 2017–2018.Participants Analysis focused on indicator results and characteristics of individual Canadian hospitals.Primary and secondary outcomes Hospital deaths (HSMR); all patients readmitted to hospital; average LOS and a series of eight hospital characteristic summary measures: number of acute care hospital stays; number of acute care beds; number of emergency department visits; average acute care resource intensity weight; total acute care resource intensity weight; hospital occupancy rate; patients admitted through the emergency department (%); patient days in alternate level of care (%).Results Comparing 2013–2014 to 2017–2018, hospital deaths (HSMR) largely declined, while readmissions increased; 69% of hospitals decreased their hospital deaths (HSMR), while 65% of hospitals increased their readmissions rates. A greater proportion of community-large hospitals (31%, n=14) improved on both hospital deaths (HSMR) and readmission compared to Teaching hospitals (13.9%, n=5). Hospital deaths (HSMR), readmission and LOS largely showed very weak and non-significant correlations. LOS was largely positively and statistically significantly correlated with the suite of eight hospital characteristics. Hospital deaths (HSMR) was largely negatively (not statistically significantly) correlated with the hospital characteristics. Readmission was largely not statistically significantly correlated and showed no clear pattern of correlation (direction) with hospital characteristics.Conclusions Examining publicly reported hospital performance results can reveal meaningful insights into the association among outcome indicators and hospital characteristics. Good or bad hospital performance in one care domain does not necessarily reflect similar performance in other care domains. Thus, caution is warranted in a narrow use of outcome indicators in the design and operationalisation of hospital performance measurement and governance models (namely pay-for-performance schemes). Analysis such as this can also inform quality improvement strategies and targeted efforts to address domains of care experiencing declining performance over time; further granular subdivision of the analyses, for example, by hospital peer-groups, can reveal notable differences in performance

Rapid identification of Salmonella in dairy products by P-CEIA

Background and Aim: Salmonella contamination is a major problem in poultry and food industry. Lack of on-time diagnosis of the bacteria may cause irreparable economic loss. Speed, repeatability and cost-benefits are the most important parameters. Faster, easier and more economic monitoring of pathogens (e.g. Salmonella.) is essential in the whole process. Routine bacterial culture methods and Antibody-Enzyme Immunoassay (ELISA) are time consuming and costly. The aim of this study was to compare Polymixin Coated Polyester Cloth (P-CEIA) with culture and ELISA in identification and rapid diagnosis of different Salmonella serovars in dairy products. Materials and Methods: In order to compare Ab-EIA and P-CEIA, different dilutions of S. typhimorium Ra-30 were prepared in peptone water (BPW, pH=7.4). From the 20 samples of milk and cream, 10 suspicious slamonella contaminated samples had been surveyed by the two methods. Results: The sensitivity of P-CEIA method was 106 cfu/ml while the sensitivity of ab-EIA was estimated to be 105 cfu/ml. The sensitivities of the two methods were equal following heat treatment in the presence of sodium deoxy-cholate. Ab-EIA detected 5 and 3 suspicious samples of milk and cream, respectively. PCEIA detected 3 and 6 of the contaminated samples. The first method required 14 hours less time than the other method.Conclusion: Our data shows that P-CEIA is a rapid, economic and sustainable method for Salmonella detection in dairy products

Volumetric storage limits and space-volume multiplexing trade-offs for holographic channels

©2010 SPIE--The International Society for Optical Engineering. One print or electronic copy may be made for personal use only. Systematic reproduction and distribution, duplication of any material in this paper for a fee or for commercial purposes, or modification of the content of the paper are prohibited. The electronic version of this article is the complete one and can be found online at: http://dx.doi.org/10.1117/1.3294886DOI: 10.1117/1.3294886We consider M-ary signaling in page-oriented holographic storage systems that multiplex pages using three methods: conventional angular multiplexing throughout the volume, localized recording, and a combination of angular multiplexing within localized recording. We study the mutual information transfer, which is increasingly easy to achieve in practice, between the recorded and recovered data, and use it to assess the storage density in these systems. We use the existing holographic channel model for the dominant Rician noise case for deriving the mutual information bound on the capacity and examine the interplay between the storage density and the number of recorded pages within the medium. We quantify through information-theoretical analysis that it is possible to obtain considerably higher storage capacities using gated localized holography than what can be achieved in conventional volume holography with angular multiplexing by appropriately optimizing the number of intensity levels for a given material constant and signal-to-noise ratio